Question Remote Physician (working from home) POS Code Clarification

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Mesa, AZ
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If a therapist (lcsw, lmf, masters level) works from THEIR home seeing patients through telehealth services, what place of service code do you use? The therapist doesn’t’t work from “office” but they work at HOME REGULARLY can I still use POS 11 or something else?
 

taylorking14

Contributor
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Nevada, OH
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If a therapist (lcsw, lmf, masters level) works from THEIR home seeing patients through telehealth services, what place of service code do you use? The therapist doesn’t’t work from “office” but they work at HOME REGULARLY can I still use POS 11 or something else?
I would say a 10 or 11.
 

csperoni

True Blue
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The CMS telehealth guidance is to use the POS you would have used if furnished in person (so 11 if office). Some carriers have differing guidance.
From CMS FAQ Section P Q5:
Question: How does a health care provider bill for telehealth services?
Answer: The IFC directs physicians and practitioners who bill for Medicare telehealth services to report the place of service (POS) code that would have been reported had the service been furnished in person. This will allow our systems to make appropriate payment for services furnished via Medicare telehealth which, if not for the PHE for the COVID-19 pandemic, would have been furnished in person, at the same rate they would have been paid if the services were furnished in person.We believe this interim change will maintain overall relativity under the PFS for similar services and eliminate potential financial deterrents to the clinically appropriate use of telehealth. During the PHE, the CPT telehealth modifier, modifier 95, should be applied to claim lines that describe services furnished via telehealth. Practitioners should continue to bill these services using the CMS-1500/837P.
 
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